Achieving an optimal physiological result without total coverage of all possible atheroma may be a compromise. With the advent of physiological mapping there is now an opportunity to assess this in detail. In an hypothesis generating analysis from the iFR-Pullback study, it was noted that physiological lesion length was significantly shorter than anatomical
length and the total stent length deployed [13]. Furthermore, virtual-PCI analysis suggested optimal physiological results could be achieved with significantly less stent length. At present these concepts are nascent, and there is no outcome data for either approach of physiologically focused stenting versus stenting covering larger lengths. Detailed future studies will be required before such an approach can be advocated.